Vocal assessment of addicts on methadone therapy via the RBH scale and objective acoustic parameters.

INTRODUCTION: A large number of people around the world struggle daily to become free of their addiction to illegal psychoactive substances. In order to create an atmosphere of improved supervision, established communication and improved quality of life for drug addicts, centers have been set up to provide methadone as a substitute. OBJECTIVE: The aim of the research was to assess the vocal features of drug addicts on methadone therapy via subjective and objective parameters, to ascertain if vocal damage has occurred and to determine whether subjective and objective acoustic vocal parameters are related, and how. METHODS: The research included 34 adults of both genders who were undergoing methadone treatment. A subjective vocal evaluation assessed voice pitch and clarity, while the subjective acoustic analysis utilized the Roughness-Breathiness-Hoarseness scale of roughness-breathiness-hoarseness. Objective acoustic analysis was conducted after recording and analyzing an uninterrupted vocal /a/ of at least three seconds duration, using the "GllotisController" software. RESULTS: The subjective acoustic analysis using the Roughness-Breathiness-Hoarseness scale showed pathological values in 52.9% male and 47% female participants. The average values of the roughness-breathiness-hoarseness for the entire sample were 0.91, 0.38 and 0.50, respectively. Lower roughness was associated with a higher fundamental frequency (f0) and lower jitter and shimmer values (p<0.05). There was a statistically significant correlation between breathiness, jitter (p<0.01) and shimmer (p<0.05), and between hoarseness and jitter (p<0.01). CONCLUSION: A statistically significant correlation was found between the two subjective vocal assessments, voice clarity and pitch, and Roughness-Breathiness-Hoarseness scale, and the parameters of the objective acoustic vocal assessment.

Resonant thermoelectric nanophotonics.

Photodetectors are typically based either on photocurrent generation from electron-hole pairs in semiconductor structures or on bolometry for wavelengths that are below bandgap absorption. In both cases, resonant plasmonic and nanophotonic structures have been successfully used to enhance performance. Here, we show subwavelength thermoelectric nanostructures designed for resonant spectrally selective absorption, which creates large localized temperature gradients even with unfocused, spatially uniform illumination to generate a thermoelectric voltage. We show that such structures are tunable and are capable of wavelength-specific detection, with an input power responsivity of up to 38 V W-1, referenced to incident illumination, and bandwidth of nearly 3 kHz. This is obtained by combining resonant absorption and thermoelectric junctions within a single suspended membrane nanostructure, yielding a bandgap-independent photodetection mechanism. We report results for both bismuth telluride/antimony telluride and chromel/alumel structures as examples of a potentially broader class of resonant nanophotonic thermoelectric materials for optoelectronic applications such as non-bandgap-limited hyperspectral and broadband photodetectors.

ARTICULATION OF SPEECH SOUNDS OF SERBIAN LANGUAGE IN CHILDREN AGED SIX TO EIGHT.

INTRODUCTION: Phonetic and phonological system of the healthy members of one linguistic community is fully formed around 8 yedrs of age. The auditory and articulatory habits are established with age and tend to be more difficult to be upgraded and completed later. MATERIAL AND METHODS: The research was done as a cross-sectional study, conducted at the preschool institution "Radosno detinjstvo" and primary school "Branko Radicevic" in Novi Sad. It included 66 children of both genders, aged 6 to 8. The quality of articulation was determined according to the Global Articulation Test by working with each child individually. RESULTS: In each individual vowel, plosive, nasal, lateral and fricative, the quality of articulation was statistically significantly better in the first graders compared to the preschool children (p<0.01). In each affricate, except for the sound /c/, the quality of articulation was statistically significantly better in the first graders than in the preschool children (p<0.01). The quality of articulation of all speech sounds was statistically significantly better in the first graders than in the preschool children (p<0.01). DISCUSSION AND CONCLUSION: The most common disorder of articulation is distortion, while only substitution and substitution associated with distortion are less common. Omission does not occur in children from 6 to 8 years of age. Girls have slightly better quality of articulation. The articulatory disorders are more common in preschool children than in children who are in the first grade of primary school. The most commonly mispronounced sounds belong to the group of affricates and fricatives.

ARTICULATION DISORDERS IN SERBIAN LANGUAGE IN CHILDREN WITH SPEECH PATHOLOGY.

INTRODUCTION: Articulation is the result of speech organs and it means clean, clear and distinct pronunciation of voices in words. MATERIAL AND METHODS: A prospective study included 24 children between 5 and 15 years of age, of both sexes. All children were monolingual, Serbian being their native language. The quality of articulation was tested with Triage articulation test. RESULTS: Neither omission nor distortion of plosives was observed in any of them, whereas substitution of plosives occurred in 12% of patients. Omission of affricates was not observed in any of the subjects, but substitution and distortion occurred in 29%, and 76% of subjects, respectively. Omission of fricatives was found in 29% subjects, substitution in 52%, and distortion in 82% of subjects. Omission and distortion of nasals was not recorded in any of the subjects, and substitution occurred in 6% of children. Omission of laterals was observed in 6%, substitution in 46% and distortion in 52% of subjects with articulation disorders. Discussion and CONCLUSION: Articulation disorders were observed not only in children diagnosed with dyslalia but in those with dysphasia and stuttering as well. Children with speech disorders articulate vowels best, then nasals and plosives. Articulation of fricatives and laterals was found to be most severely deviated, including all three disorders, i.e. substitution, omission and distortion. Spasms of speech muscles and vegetative reactions were also observed in this study, but only in children with stuttering.

Possible factors of success in teaching esophageal speech.

INTRODUCTION: Well-established esophageal voice and speech is the most human-like form of communication of laryngectomized patients. MATERIAL AND METHODS: The study sample consisted of 28 patients of the Department of Ear. Nose and Throat, Clinical Center of Vojvodina in Novi Sad. All patients underwent total laryngectomy because of laryngeal cancer previously confirmed. The patients were divided into two groups based on the success of mastering esophageal voice and speech, group I being successful and group 2 being unsuccessful. Results. All patients were subjected to total laryngectomy and had their hyoid bone removed (100%). Esophageal speech was rated excellent afid good in 71% and 29% of patients from group 1, respectively. There was no significant difference between the successful (group 1) and unsuccessful group (group 2) in time when teaching began (chi2=5.14, p=0.023). Neither was there a statistically significant difference between these two groups regarding the methods applied in teaching esophageal. speech (chi2 = 2.02, p=0.155, which is greater than 0.05). CONCLUSION: The effectiveness of teaching esophageal speech depends significantly on the motivatidn of the patients. It was found that the patients who mastered esophageal speech successfully had'been learning it longer than those who did not master it. The success in mastering esophageal speech did not depend on whether the patients were trained individually or collectively, whereas neither method of training was successful in group 2.

High-throughput on-the-fly scanning ultraviolet-visible dual-sphere spectrometer.

We have developed an on-the-fly scanning spectrometer operating in the UV-visible and near-infrared that can simultaneously perform transmission and total reflectance measurements at the rate better than 1 sample per second. High throughput optical characterization is important for screening functional materials for a variety of new applications. We demonstrate the utility of the instrument for screening new light absorber materials by measuring the spectral absorbance, which is subsequently used for deriving band gap information through Tauc plot analysis.

Colorimetric screening for high-throughput discovery of light absorbers.

High-throughput screening is a powerful approach for identifying new functional materials in unexplored material spaces. With library synthesis capable of producing 10(5) to 10(6) samples per day, methods for material screening at rates greater than 1 Hz must be developed. For the discovery of new solar light absorbers, this throughput cannot be attained using standard instrumentation. Screening certain properties, such as the bandgap, are of interest only for phase pure materials, which comprise a small fraction of the samples in a typical solid-state material library. We demonstrate the utility of colorimetric screening based on processing photoscanned images of combinatorial libraries to quickly identify distinct phase regions, isolate samples with desired bandgap, and qualitatively identify samples that are suitable for complementary measurements. Using multiple quaternary oxide libraries containing thousands of materials, we compare colorimetric screening and UV-vis spectroscopy results, demonstrating successful identification of compounds with bandgap suitable for solar applications.

Articulation of sounds in Serbian language in patients who learned esophageal speech successfully.

INTRODUCTION: Articulation of pronounced sounds during the training and subsequent use of esophageal speech is very important because it contributes significantly to intelligibility and aesthetics of spoken words and sentences, as well as of speech and language itself. The aim of this research was to determine the quality of articulation of sounds of Serbian language by groups of sounds in patients who had learned esophageal speech successfully as well as the effect of age and tooth loss on the quality of articulation. MATERIAL AND METHODS: This retrospective-prospective study included 16 patients who had undergone total laryngectomy. Having completed the rehabilitation of speech, these patient used esophageal voice and speech. The quality of articulation was tested by the "Global test of articulation." RESULTS: Esophageal speech was rated with grade 5, 4 and 3 in 62.5%, 31.3% and one patient, respectively. Serbian was the native language of all the patients. The study included 30 sounds of Serbian language in 16 subjects (480 total sounds). Only two patients (12.5%) articulated all sounds properly, whereas 87.5% of them had incorrect articulation. CONCLUSION: The articulation of affricates and fricatives, especially sound /h/ from the group of the fricatives, was found to be the worst in the patients who had successfully mastered esophageal speech. The age and the tooth loss of patients who have mastered esophageal speech do not affect the articulation of sounds in Serbian language.

Paradoxical movements of the epiglottis--a rare cause of respiratory obstruction and its surgical treatment.

INTRODUCTION: The aim of this paper was to present a rare disorder of epiglottis function as a cause of breathing disorders and a manner of dealing with this problem. CASE REPORT: A 59-year-old male patient had breathing disorders in the form of short cessations of breathing two months after a cardiac surgery. He could not tolerate even a slight physical effort. Indirect laryngoscopy and video endoscopy performed with a rigid endoscope indicated paradoxical movements of epiglottis, which closed the entrance to the larynx and caused short cessations of breathing. The patient underwent a subtotal resection of the epiglottis with an argon plasma scalpel. Directoscopy of the larynx was performed under general endotracheal anesthesia. After three weeks, the patient was without any difficulties. The check-up examination after three months showed a small remaining part of the epiglottis. There were no paradoxical movements of the vocal folds: the left vocal fold was shorter, with a loose edge, and the posterior region of the glottis tilted to the left in phonation. The patient reported no breathing disorders three months after the operation. DISCUSSION: Airway obstruction can be reduced significantly by surgical treatment of a soft or hanging epiglottis. Subtotal resection by argon plasma scalpel resulted in termination of breathing disorders in the patient described in this paper, and it enabled him to continue his normal everyday activities. CONCLUSION: Paradoxical movements of the epiglottis are a rare cause of breathing disorders. Resection of the epiglottis is a method which gives good therapeutic results.

Voice therapy and assistive techniques in voice disorders caused by unilateral vocal cord pareses.

INTRODUCTION: Dysphonias due to primary neurogenic disorders are a group of voice disorders that can be caused by both central and peripheral disorders of the larynx innervation. There are numerous causes leading to paralysis of superior and/or inferior laryngeal nerves, particularly of the inferior laryngeal or recurrent nerve. VOICE THERAPY IN UNILATERAL VOCAL CORD PARESIS: Vocal therapy is an integral part of the conservative treatment. Specific methods are applied to individual vocal problems, while the non-specific ones are applied to a number of dysphonias. Non-specific methods are further divided into integrated and focused vocal methods. Integrated methods treat the voice and speech disorders as a unified entity of all quality and segments of voice and speech. Focused non-specific methods treat the segments and the quality of voice and speech individually. ASSISTIVE TECHNIQUES IN VOICE DISORDERS CAUSED BY UNILATERAL VOCAL CORD PARESIS: Digital compression of the larynx by Seeman includes the treatment of voice with compression of the thyroid cartilage, thus moving the paralyzed and healthy vocal cord medially and upwards, and medially and downwards, respectively. This leads to the proper occlusion of vocal cords because in these conditions the paralyzed vocal cord is lower than the healthy one. According to the theoretical assumption, when the head anc neck are rotated to one or the other side, the anatomic relations in the neck are change and thus the vocal cords are brought into contact with the resulting reduction of the gap between them and the reduced air flow. CONCLUSION: Studies assessing the efficiency of different methods of vocal therapy are scarce bearing in mind the importance of vocal therapy and the fact that many patients refuse surgical treatment. Research on the efficiency of assistive techniques in phoniatric rehabilitation of patients with unilateral vocal cord paresis yields conflicting results. However, assistive techniques are useful practical methods in vocal rehabilitation of these patients.

Oesophageal food bolus impaction in elderly people.

INTRODUCTION: The diagnosis of food bolus impaction in the esophagus is based on the data obtained from the patient, clinical examination, radiographic diagnosis, and endoscopy. The aim of this study was to examine the influence of possible factors causing oesophageal impaction of food boluses in elderly people. MATERIAL AND METHODS: This retrospective study included six male and eight female patients treated at the Department of Ear, Nose, and Throat Disease in Novi Sad. RESULTS: Post-corrosive oesophageal stricture was diagnosed in 28.57% of patients and non-corrosive stricture was found in 21.43%. Total tooth loss was recorded in 64.29% of patients and 14.29% of patients had partial tooth loss. An impacted food bolus was located at a distance of 15-25 cm or 30-40 cm distance from the upper incisors in 42.86% of the study sample. DISCUSSION AND CONCLUSION: The impaction of food boluses in the esophagus is significantly higher in women, usually after 76 years of age. There is a positive correlation between the presence of oesophageal stricture and recurrence of food bolus impaction. Partial and total tooth loss is present in a high percentage but there is no correlation with the food bolus impaction. Impaction of food bolus was equally found in the upper and lower third of the oesophagus and it was usually meat. Radiographic diagnosis should precede each esophagoscopy. Esophagoscopy with rigid oesophagoscope is a reliable method for the extraction of a bolus of food from the oesophagus in elderly patients.

Mapping quantum yield for (Fe-Zn-Sn-Ti)Ox photoabsorbers using a high throughput photoelectrochemical screening system.

Combinatorial synthesis and screening of light absorbers are critical to material discoveries for photovoltaic and photoelectrochemical applications. One of the most effective ways to evaluate the energy-conversion properties of a semiconducting light absorber is to form an asymmetric junction and investigate the photogeneration, transport and recombination processes at the semiconductor interface. This standard photoelectrochemical measurement is readily made on a semiconductor sample with a back-side metallic contact (working electrode) and front-side solution contact. In a typical combinatorial material library, each sample shares a common back contact, requiring novel instrumentation to provide spatially resolved and thus sample-resolved measurements. We developed a multiplexing counter electrode with a thin layer assembly, in which a rectifying semiconductor/liquid junction was formed and the short-circuit photocurrent was measured under chopped illumination for each sample in a material library. The multiplexing counter electrode assembly demonstrated a photocurrent sensitivity of sub-10 µA cm(-2) with an external quantum yield sensitivity of 0.5% for each semiconductor sample under a monochromatic ultraviolet illumination source. The combination of cell architecture and multiplexing allows high-throughput modes of operation, including both fast-serial and parallel measurements. To demonstrate the performance of the instrument, the external quantum yields of 1819 different compositions from a pseudoquaternary metal oxide library, (Fe-Zn-Sn-Ti)Ox, at 385 nm were collected in scanning serial mode with a throughput of as fast as 1 s per sample. Preliminary screening results identified a promising ternary composition region centered at Fe0.894Sn0.103Ti0.0034Ox, with an external quantum yield of 6.7% at 385 nm.

Giant antrochoanal polyp--case report and literature review.

INTRODUCTION: Antrochoanal polyp is a benign tumor of the maxillary sinus mucosa passing through the sinus ostium into the nasal cavity. Nasal obstruction is the most common symptom in all patients. CASE REPORT: The authors present a case of a 28-year old female who was admitted to hospital with breathing difficulty, unilateral nasal secretion, headache and deformity of the nasal pyramid. Computerized tomography examination of the nose and paranasal sinuses indicated a possibility of giant antrochoanal polyp. The antrochoanal polyp was extirpated completely using forceps, under general endotracheal anesthesia. The length of the giant polyp was 16 cm. A follow-up examination of the nose and the right maxillary sinus was performed using a rigid endoscope, but no remains of the polyp were found. CONCLUSION: The authors believe that this is probably the first or a very rare published case of complete extirpation of a giant antrochoanal polyp of this size.

Laryngotracheal stenosis and restenosis. What has the influence on the final outcome?

The aim of this study is to analyze the impact of various parameters on the course and treatment outcome in patients with laryngotracheal stenosis and recurrent stenosis. Two groups of patients were compared: Group I included 29 patients with primary stenosis, and Group II included 22 patients with recurrent stenosis. The most frequent etiological factor for the development of stenosis was prolonged endotracheal intubation (79.3:77.3%), with subglottic-tracheal (44.8:45.5%) and tracheal (48.3:36.4%) localization being the most affected. Subglottic-tracheal stenosis was more common in men. There were no significant differences between the groups in regard to the grade of lumen obstruction and the length of the resected segment. In male patients, the length of the resected stenotic segment was significantly longer. Subglottic-tracheal stenoses were longer than tracheal ones. Various surgical procedures were performed, with additional management of recurrent laryngeal nerve paralysis, if necessary. Laryngotracheal reconstruction (LTR) with costal cartilage grafting (CCG) was statistically significantly more often performed in Group II, while cricotracheal resection (CTR) was more common in Group I. The incidence of complications in Group I was 24.1%, and in Group II it was 31.8%. Satisfactory airway lumen with undisturbed breathing was achieved in 93.1% of patients in Group I, and in 95.3% in Group II. Since the success rate was similar in both groups of the patients, it could be concluded that treatment outcome depends less on the factors associated with the stenosis, and more on adequate choice of surgical procedure and surgical team know-how.

Effect of vacuum-treatment on deformation properties of PMMA bone cement.

Deformation behavior of polymethyl methacrylate (PMMA) bone cement is explored using microindentation. Two types of PMMA bone cement were prepared. Vacuum treated samples were subjected to the degassing of the material under vacuum of 270 mbar for 35 s, followed by the second degassing under vacuum of 255 mbar for 35 s. Air-cured samples were left in ambient air to cool down and harden. All samples were left to age for 6 months before the test. The samples were then subjected to the indentation fatigue test mode, using sharp Vickers indenter. First, loading segment rise time was varied in order to establish time-dependent behavior of the samples. Experimental data showed that viscous part of the deformation can be neglected under the observed test conditions. The second series of microindentation tests were realized with variation of number of cycles and indentation hardness and modulus were obtained. Approximate hardness was also calculated using analysis of residual impression area. Porosity characteristics were analyzed using CellC software. Scanning electron microscopy (SEM) analysis showed that air-cured bone cement exhibited significant number of large voids made of aggregated PMMA beads accompanied by particles of the radiopaque agent, while vacuum treated samples had homogeneous structure. Air-cured samples exhibited variable hardness and elasticity modulus throughout the material. They also had lower hardness values (approximately 65-100 MPa) than the vacuum treated cement (approximately 170 MPa). Porosity of 5.1% was obtained for vacuum treated cement and 16.8% for air-cured cement. Extensive plastic deformation, microcracks and craze whitening were produced during indentation of air-cured bone cement, whereas vacuum treated cement exhibited no cracks and no plastic deformation.

Reduction of thermal conductivity in phononic nanomesh structures.

Controlling the thermal conductivity of a material independently of its electrical conductivity continues to be a goal for researchers working on thermoelectric materials for use in energy applications and in the cooling of integrated circuits. In principle, the thermal conductivity κ and the electrical conductivity σ may be independently optimized in semiconducting nanostructures because different length scales are associated with phonons (which carry heat) and electric charges (which carry current). Phonons are scattered at surfaces and interfaces, so κ generally decreases as the surface-to-volume ratio increases. In contrast, σ is less sensitive to a decrease in nanostructure size, although at sufficiently small sizes it will degrade through the scattering of charge carriers at interfaces. Here, we demonstrate an approach to independently controlling κ based on altering the phonon band structure of a semiconductor thin film through the formation of a phononic nanomesh film. These films are patterned with periodic spacings that are comparable to, or shorter than, the phonon mean free path. The nanomesh structure exhibits a substantially lower thermal conductivity than an equivalently prepared array of silicon nanowires, even though this array has a significantly higher surface-to-volume ratio. Bulk-like electrical conductivity is preserved. We suggest that this development is a step towards a coherent mechanism for lowering thermal conductivity.

Surgical treatment of primary tracheal dyskinesia in a 14-month-old child--case report.

The primary form of tracheal dyskinesia in early childhood is a rare congenital malformation of unknown origin. The degree of the posterior membranous tracheal wall involvement determines the intensity of obstruction and the severity of the clinical picture. The aim of this paper is to present a case of a 14-month-old child with severe tracheal dyskinesia that required surgical treatment. Fascia lata graft fixated with fibrin glue was used in strengthening the posterior tracheal wall. Three years following the surgery, the child is without breathing difficulties. In severe cases of primary dyskinesia, surgical treatment using fascia lata graft, fixated with fibrin glue is recommended in strengthening the posterior tracheal wall.

[Difficulties and complications of using endo-extralaryngeal laterofixation of vocal cords in bilateral recurrent laryngeal nerve palsy].

INTRODUCTION: The aim of this study is to show our experience in using the endo-extralaryngeal laterofixation of vocal cords in treatment of bilateral recurrent laryngeal nerve palsy, and to point out the difficulties and complications of this procedure and the ways of their managing. MATERIAL AND METHODS: During the period from 2003 to 2006, 14 patients with bilateral palsy of the recurrent laryngeal nerve were treated with method of Lichtenberger's endo-extra laryngeal laterofixation of the vocal cord The patients were 12 female and 2 male from 26 to 78 (average 57.4) years old. The earliest intervention was performed 8 day after the onset of paresis and not later than 40 days. RESULTS: In 11/14 (78.6%) of the patients bilateral palsy of the recurrent laryngeal nerve occured as a result of thyroid gland surgery. At the admission 2 (14.3%) patients had tracheostomy while 12 (85.7%) had no tracheostomy. Edema was the most often complication of the endo extra laryngeal laterofixation and it appeared in 8/14 (57.1%) patients. The earliest swelling of the laryngeal tissue was recorded on the first postoperative day and the latest one started 7 days after the intervention. Edema developed in 7/11 (63.6%) after total thyreoidectomy, in 1/3 (33.3%) with traumatic injuries in the neck Because of progression of the edema which provoked narrowing of the airway at the laryngeal level tracheostoma was peformed in 2 patients. Inflammation of laryngeal tissue with sudden obstruction of the airway resulted in death in one patient. Malposition of the thread toward the midle part of the vocal cord happened very often if intervention was not performed in JET ventilation anesthesia. The vocal card function was repaired bilaterally in 2 patients and unilaterally in 1 patient (the total being 3 out of 14 patients, i.e. 21.4%) four months after the laterofixation, and the threads were removed. Lung functional test showed the increase in average value PEF% from 26.53 before to 39.43 after laterofixation, and PIF from 0.83 before to 1.19 after intervention. Resistance R% in the upper airway decreased from the average 257.95 as before to 215.83 after the intervention, while the index FEV1.0/PEF (ml/L/min) remained almost the same before 13.25 and after the intervention 13.50 and that showed that the upper airway obstruction, in spite of good clinical tolerance by the patients, still persisted in all patients after the laterofixation. CONCLUSIONS: Lichtenberger's endo-extra laryngeal laterofixation of the vocal cord is a good alternative method for bilateral palsy of the recurrent laryngeal nerve which provide sufficient upper airway without tracheostomy.